Sweaty Palms?

Getting Ahead of Head Injuries in Sports and Recreation

May 12, 2011

Katharine M. Nohr, Esq.
Nohr Sports Risk Management, LLC

On March 18, 2009, headlines all over the world announced that actress Natasha Richardson died from a head injury she sustained from a fall on a Quebec ski slope. An autopsy revealed that she sustained an epidural hematoma, causing bleeding between the skull and the brain’s covering. Such bleeding from a skull fracture may quickly produce a blood clot which puts pressure on the brain, forcing the brain downward. This impacts the brain stem that controls vital functions, including breathing. Logically, if all of that is happening it should be obvious and immediate medical attention would be sought. That is not the case. It is common for people that suffer head injuries to feel fine initially as it takes some time before symptoms emerge. Dr. Keith Siller of New York University Langone Medical Center, when interviewed in relation to this tragedy explained that, “This is a very treatable condition if you’re aware of what the problem is and the patient is quickly transferred to a hospital.”

The news coverage about Natasha Richardson, generally reported that she was a beginning skier who declined to wear a helmet for her ski lesson. She felt fine after her fall and turned an ambulance away at approximately 1:00pm. She later developed a headache and medics returned at approximately 3:00pm. As her condition deteriorated, she was driven from a local hospital to a Montreal hospital, not arriving until approximately 7:00pm. There were no medivac helicopters or airplanes available.

What risk management lessons can be gleaned from the above information? First, head injuries can occur in many different sports, not just skiing. Consider the possibility of head injuries from falls in other sports, such as football, basketball, baseball, soccer, ice hockey, equestrian, skateboarding, cycling, or gymnastics. There is a chance that someone could fall and hit their head in any sport, even those sports where players do not ordinarily wear helmets, such as gymnastics, soccer or basketball. For sports that require or strongly recommend helmets, does your organization require athletes of all ages to wear helmets? Are the rules related to mandatory helmet wearing enforced? Are helmets checked to make sure that they meet certain safety standards, such as those provided by the U.S. Consumer Product Safety Commission? Is proper fit of helmets required? Are athletes required to have their helmet on at all times while on the field of play or performing the activity? Are chin straps secured at all times? Can you think of other concerns that you may have about proper use of helmets?

The second risk management lesson that can be learned from Ms. Richardson’s unfortunate death is that when someone has any type of head injury, medical attention should immediately be sought and they should not resume play or activity until a doctor has cleared them to do so. This may seem too obvious to point out, but there have been numerous lawsuits against sports organizations, coaches and events, that have arisen out of scenarios similar to this one. If your organization has not established a policy to address head injuries, this is the time to do so.